Stricken ill or injured in a foreign country--where the language and the surroundings are unfamiliar--most travelers are confounded by the question, "Where and how can I find a good doctor?" It's a question most don't ask until they must.
Fortunately, this is getting easier, thanks to a number of options.
Some credit card companies offer medical assistance abroad as a benefit to cardholders. American Express, for example, has a medical referral service called Global Assist, as a membership benefit. Members simply call the 24-hour, toll-free number printed on the back of the card (800-554-AMEX) to get help in finding medical services. The operator attempts to set up an appointment with a doctor, rather than just giving the traveler a name and phone, according to Julie McCashin of American Express.
A similar service is offered to Gold MasterCard members. Called MasterAssist Medical Protection, it promises referrals for those with medical emergencies who are traveling more than 50 miles from home. Outside the U.S., cardholders can call collect (214-994-9843) around the clock and are referred to local doctors, dentists, hospitals and pharmacies. The service also relays emergency messages to families and co-workers and will help arrange the transportation of a family member or friend to the ill or injured person's bedside. The referral is free; other costs are the cardholder's responsibility.
Spokeswomen for both credit card companies say they screen their providers regularly and depend on a worldwide network of medical experts to evaluate new health care providers. American Express, for example, seeks doctors who are U.S. trained and board-certified in their specialty. The list is updated about every 12 to 18 months, McCashin said. Monitoring care is another important step. "We call the doctor who saw you, just to be sure (the treatment) makes sense," McCashin said.
Similarly, Visa Gold and Business card holders can get advice on finding doctors in the area they are visiting by calling, from anywhere in the world, a toll-free number provided them. Visa will also help set up phone consultations with U.S. doctors.
Another service offered by credit card companies is a guarantee to pay medical expenses. This can be important at facilities that will not initiate treatment until payment is made or ensured.
Reading the fine print of a bank card travel assistance service is wise, since some countries are excluded from coverage. The Gold MasterCard's medical assistance program, for example, does not cover travelers in Vietnam, Iran, North Korea, Afghanistan, Laos and Sri Lanka, and other countries may be excluded from time to time, should they be deemed unsafe.
Another way to access medical care abroad is through special travel insurance that includes "doctor locater" services. Access America (804-285-3300), a company that sells insurance for travelers, has established a 24-hour hot line staffed with medical professionals and multilingual workers who hook up policy holders with doctors, dentists and hospitals around the world, a spokeswoman said.
The coverage is often not expensive, said Richard Schroeder, spokesman for Europ Assistance International (800-346-2832), another travel insurance company that offers such a service. One policy sold by his company costs $40 for an individual for up to eight days of travel and $60 for a family. In addition to putting travelers in touch with local doctors, dentists, hospitals and clinics, the service can also locate an interpreter. Replacement of lost or stolen prescription medications and eyeglasses is included in the package.
Directories of English-speaking doctors can also be useful, when traveling abroad. One such directory, published by the International Assn. for Medical Assistance to Travelers (IAMAT), a nonprofit foundation, includes English-speaking doctors in more than 500 countries, who are trained in the U.S., Great Britain or Canada, according to a foundation spokeswoman. Request the free directory from IAMAT, 417 Center St., Lewiston, N.Y. 14092.
Two other good sources of help in finding physicians are hotel concierges and American embassies. They can usually provide names of doctors and dentists, although not all will be English speaking, and their information may be lists rather than recommendations, according to a State Department spokeswoman.
Travelers also can improve the chances of getting quality care overseas by taking a few simple precautions before departure.
* If you have a chronic condition, ask your doctor to explain it in a brief letter you can carry. If you are on medication, take a list that includes generic and brand names, and jot down the strength of the tablet or solution.
* Carry a phrase book to help communicate with a foreign doctor.
* Take along your insurance card or policy number; it might make it easier for the foreign provider to communicate with your insurance company.
* Ask for an itemized bill in English. It may improve the chances of later reimbursement.